Barack Obama's healthcare reforms have been passed by the House of Representatives in America marking an historic victory for the president.
Politicians voted 219-212 to approve the Senate-passed legislation.
Applauding the vote Mr Obama said: "This isn't radical reform, but it is major reform.
"This legislation will not fix everything that ails our health care system, but it moves us in the right direction ... this is what change looks like."
Democrats used their majority to muscle the measure through, losing 34 conservative party members who joined the united Republican opposition.
Sky's Greg Milam said: "This is an historic night for the the USA and certainly for Barack Obama who staked so much of his reputation on this piece of legislation.
"If it had not been passed there would have been serious questions about what Barack Obama could have achieved both domestically and internationally.
"That's why this could be a turning point for the president."
The overhaul will extend healthcare coverage to some 32 million Americans who currently lack it.
Republicans denounced the plan, and made frequent trips to a Capitol balcony to cheer on hundreds of protesters outside demanding they "kill the bill".
After a year of often bitter debate, Mr Obama cleared the way for his own victory with an 11th-hour deal to sign an executive order reaffirming a longstanding US ban on government funding for abortions.
That won support for the bill from a group of conservative Democratic holdouts.
The breakthrough ensured that Mr Obama's Democratic allies could lock down the 216 votes needed to ensure passage of the sweeping legislation.
The House vote on what Mr Obama has called "the toughest insurance reforms in history" would come a century after president Theodore Roosevelt first called for a national approach to US health care.
Sky's White House Commentator Jon-Christopher Bua said: "With a vote of 219 to 212 the Democrats passed Health Care Reform to shouts of 'Yes We Can!'.
"Despite its flaws this historic piece of health care legislation is the first step in reforming a broken system that has failed to cover over 30 million Americans.
"What is not clear is who wins with the passage of this legislation in the Mid-Term Election.
"The answer is probably President Obama. What is less clear is whether the Democrats will maintain their majority or the Republicans will make the most of this vote on November second to the Democrats peril."
Applauding the vote Mr Obama said: "This isn't radical reform, but it is major reform.
"This legislation will not fix everything that ails our health care system, but it moves us in the right direction ... this is what change looks like."
Democrats used their majority to muscle the measure through, losing 34 conservative party members who joined the united Republican opposition.
Sky's Greg Milam said: "This is an historic night for the the USA and certainly for Barack Obama who staked so much of his reputation on this piece of legislation.
"If it had not been passed there would have been serious questions about what Barack Obama could have achieved both domestically and internationally.
"That's why this could be a turning point for the president."
The overhaul will extend healthcare coverage to some 32 million Americans who currently lack it.
Republicans denounced the plan, and made frequent trips to a Capitol balcony to cheer on hundreds of protesters outside demanding they "kill the bill".
After a year of often bitter debate, Mr Obama cleared the way for his own victory with an 11th-hour deal to sign an executive order reaffirming a longstanding US ban on government funding for abortions.
That won support for the bill from a group of conservative Democratic holdouts.
The breakthrough ensured that Mr Obama's Democratic allies could lock down the 216 votes needed to ensure passage of the sweeping legislation.
The House vote on what Mr Obama has called "the toughest insurance reforms in history" would come a century after president Theodore Roosevelt first called for a national approach to US health care.
Sky's White House Commentator Jon-Christopher Bua said: "With a vote of 219 to 212 the Democrats passed Health Care Reform to shouts of 'Yes We Can!'.
"Despite its flaws this historic piece of health care legislation is the first step in reforming a broken system that has failed to cover over 30 million Americans.
"What is not clear is who wins with the passage of this legislation in the Mid-Term Election.
"The answer is probably President Obama. What is less clear is whether the Democrats will maintain their majority or the Republicans will make the most of this vote on November second to the Democrats peril."
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